Fatty liver: How to spot it, avoid it and beat it

Dr. Sneha Ganatra
November 23, 2020

Your body stores and utilises nutrients as needed, and each type of nutrient has a role to play towards optimal body function. This is true even for fat, which is often demonised in the pursuit of weight loss today. It is important to know that consuming sufficient good fat from your diet helps you stay healthy. However, a problem known as fatty liver disease arises when there is a high level of fatty infiltration of the liver. Alcohol consumption is among the top causes of having a fatty liver and without proper treatment, the consequences can be dire.

Since fatty liver disease has very serious health complications, including organ failure, it is well worth it to know all you can about the disease. This way, you can identify the warning signs early on before they turn into symptoms and better yet, get a conclusive diagnosis before the fatty liver condition worsens. To answer key questions and give insight on this condition, here’s a breakdown of the fatty liver condition.

What is fatty liver?

To understand what a fatty liver means, it is important to note that having small amounts of fat within the liver is perfectly normal. It is when excess fat, more than 5%, accumulates in the liver that problems start to arise. Fatty liver is also known as hepatic steatosis and having a fatty liver can cause the liver to scar, which leads to further complications.

When it comes to fatty liver disease, there are 2 main types: alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). Within these two types there are several subtypes and each presents differently. Here is a detailed breakdown to help you understand the fatty liver disease better.

  1. Alcoholic fatty liver disease (AFLD)
    Consuming alcohol excessively damages the liver and this restricts its ability to break down fat. This is the first stage of alcohol-related liver disease and if there’s no inflammation of the liver, it is called simple alcoholic fatty liver.
  2. Alcoholic steatohepatitis (ASH)
    Also known as alcohol hepatitis, this occurs when the build-up of fat in the liver is also accompanied by inflammation. If left untreated, ASH can cause cirrhosis, which is liver scarring, and can lead to liver failure.
  3. Non-alcoholic fatty liver disease (NAFLD)>
    This is a reversible stage of liver disease, and occurs amongst those who drink little to no alcohol. NAFLD often goes undiagnosed until it worsens and may be called grade 1 fatty liver. Here, in most cases, fat builds up in the liver and can present without inflammation. However, if left untreated, which is likely, it can worsen to cause other problems like cirrhosis, heart disease or liver cancer.
  4. Non-alcoholic steatohepatitis (NASH)
    NASH is when there is excess fat in the liver and there is inflammation that can damage liver cells. It may be called grade 2 fatty liver. Common problems due to NASH include fibrosis or scar tissue due to the liver cells constantly being injured.
  5. Acute fatty liver of pregnancy (AFLP)
    This is quite a rare form of liver disease and occurs during the third trimester of pregnancy. It poses a great risk for the mother and baby, often requiring immediate delivery, as early as possible. The effects of this liver disease may be felt by both the mother and child, with the mother requiring additional care post-delivery.

Fatty liver causes

Simply put, fatty liver is caused when the body doesn’t metabolise fat efficiently, which causes a build-up of fat in the liver as a result. Other causes for fatty liver disease include:

  • Alcohol consumption
  • Insulin resistance
  • High blood sugar
  • Obesity
  • Excess belly fat
  • Pregnancy
  • Exposure to toxins
  • Hepatitis C
  • Side-effects of medication
  • Impaired gut health

Besides these causes, there are also other factors that increase the risk of developing a fatty liver. They are as follows.

  • Polycystic ovary syndrome (PCOS)
  • Metabolic syndrome
  • High cholesterol

Fatty liver symptoms

In general, a fatty liver doesn’t have many noticeable symptoms at the start. It is only when it worsens and causes inflammation or cirrhosis that the afflicted may experience some discomfort. Here are the symptoms to keep an eye out for.

  • Nosebleeds
  • Swelling in the legs
  • Breast enlargement in men
  • Abdominal pain
  • Yellow eyes and skin
  • Fatigue
  • Loss of appetite
  • Itchy skin
  • Weakness
  • Weight loss
  • Abdominal swelling
  • Confusion